Anyone with a high Oncotype and <1 cm tumor

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knowledgeforpower
knowledgeforpower Member Posts: 184
edited June 2014 in IDC (Invasive Ductal Carcinoma)

The pathology report for my lumpectomy revealed an 8 mm tumor which is  grade 3, mitotic count  of 2, the cells were very undifferentiate.  The DCIS component was comedo with necrosis also a grade 3.  My marign are clear and my SNB was negative.  I am Er positve and Her2 negative. The medical oncologist sent the tumor for Oncotype. She seems to think although it's small it is aggressive.  Anyone have a high Oncotype on such a small tumor?

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2009

    There is a thread here called "OncotypeDx roll call" or something similar to that...you might read through it as lots of ladies have posted their stats with their onco score..

    My tumor was 2.4 cm, but grade 1 and my onco score was 12.

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  • jude14
    jude14 Member Posts: 293
    edited February 2009

    I had a 1.5 cm tumor with a high grade of three that was comedo type and my onco score was an 18.   I did not do chemo did the rads and on femara.  They got clean margins on my lumpectomy also and clean nodes  Good luck with the onco score

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  • mzmiller99
    mzmiller99 Member Posts: 894
    edited February 2009

    Mine was very similar, Jude...clena margins, clean nodes, and my onco score was 15.  No chemo. 

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  • gramadeb
    gramadeb Member Posts: 210
    edited February 2009

    Mine was 1.2 cm grade 3. My surgeon told me right after surgery to expect chemo because of the high grade. My oncotype came back at 28 and yes, I had chemo, rads and on arimidex. I know exactly where you are coming from. I fretted about the grade 3 and what it really meant in relationship to aggressive form while waiting for my oncotype results. Not all grade 3 require chemo. I will keep my fingers crossed that your oncotype comes back low. If however, you do need chemo - it is doable - not pleasant but doable. My mammo last week - first one after treatment - came back "normal". I feel like I did all I could to be bc.

    Deb

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  • Emily2008
    Emily2008 Member Posts: 605
    edited February 2009

    I think Otter's tumor was either 1 cm or <1, and her Oncotype was 26, I believe.  You should PM her.

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  • Tamara67646
    Tamara67646 Member Posts: 293
    edited February 2009

    I had a 7mm tumor, grade 2 and my oncotype came back at 25 so I did chemo.

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  • otter
    otter Member Posts: 6,099
    edited February 2009

    My tumor was larger--it was 1.8 cm, Grade 2 with an Oncotype score of 26.  There isn't a direct relationship between histologic grade ("aggressiveness") and Oncotype score.  If there was, nobody would be spending $3,500 on Oncotype testing.  Looking at the tissue under a microscope to determine the histologic grade is a lot faster and cheaper.

    What that means is, sometimes very small tumors have high Oncotype scores; sometimes tumors with high histologic grade have low Oncotype scores.  Unfortunately, when the results aren't consistent, it makes the decisions more difficult. 

    otter 

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  • Emily2008
    Emily2008 Member Posts: 605
    edited February 2009

    Ooops, got your tumor size wrong, Otter.  Sorry!  That's almost as bad as guessing someone's weight at more than they actually are, LOL!

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  • Alo123
    Alo123 Member Posts: 308
    edited February 2009

    yup...7mm......26 oncoype..doing 4 rounds TC chemo 3 weeks apart...

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  • SecretCancer
    SecretCancer Member Posts: 34
    edited February 2009

    Meet the Queen of high oncotype scores......7mm tumor...Oncotype Score: 65!!

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  • Emily2008
    Emily2008 Member Posts: 605
    edited February 2009

    oh my goodness, Kim!  what in the world?  i've never heard of such a high score!!!  you really had a nasty bugger, didn't you?  here's hoping you, and all of us, are kicking them to the curb!

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  • ChrisBern
    ChrisBern Member Posts: 33
    edited May 2009

    I'm the king of high Oncotype score wuth HER2-: 0.8 centimeter - Oncotype score: 33!!!

     Chris

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  • reen
    reen Member Posts: 164
    edited May 2009

    I just looked through my whole Path Report and couldn't find anything about a Oncotype.  Now I'm curious.

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  • knowledgeforpower
    knowledgeforpower Member Posts: 184
    edited May 2009

    Oncotype is a test run on a small piece of your tumor.  The test is done in California.  It is usually done on node negative, ER positve tumors.  The test takes about 2 weeks.  The test results come back as a number.  The number can help determine if you need chemotherapy.  For me, my number was 26, so even though my tumor was .8 cm and I was node negative I did 4 rounds of AC.  Without chemotherapy the chance of recurrence was 17% and with chemo it is 12%.  The percentages are also based on taking either Tamoxifen or an aromatase inhibitior for 5 years.  You can learn more about the Oncotype test here

    http://www.genomichealth.com/OncotypeDX/Index.aspx?Sid=33

    Also discuss it with your surgeon or medical oncologist.

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  • elisheva
    elisheva Member Posts: 80
    edited June 2009

    There is an excellent article describing the Oncotype DX assay (test) right here on this website. You can find it by typing it in the Search box at the homepage or click on the link below. Also there are some additional resources that are very helpful.  http://www.breastcancer.org/symptoms/testing/types/oncotype_dx.jsp

    My surgeon submitted my tissue for the Oncotype test almost two weeks ago, but I will not find out the result until meeting her on 6/8 (had a re-excision, therefore the delay.) Can't wait. I want to get on with it already. The waiting is killing me. elisheva.

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  • mmm5
    mmm5 Member Posts: 1,470
    edited June 2009

    Kim and others-

    Dont worry about such a high Oncotype score of 66 with your situation, if you are Her2 positive you automatically get a high oncotype. They have not added the benefit of Herceptin to the early stage BC"s at Oncotype which is too new. They still only use FEC treatment which is somewhat ineffective with Her2 tumors. If you do Herceptin now with early stage 1 no node BC the stats are very good, just as good as a non HER2 stage 1 with just ERPR positive. There are studies that show these stats. The Oncotype just has not caught up with this treatment route yet.

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  • rdrake0
    rdrake0 Member Posts: 180
    edited June 2009

    Age is a factor with deciding on chemo, as I found out.  My onco score was 26.  Two different Onco docs said no to chemo for me due to my age, 60.  Hope they were right.  I don't feel that old!  (When I was 30 and 40, 60 looked darn old!  Not anymore, though!)

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  • elisheva
    elisheva Member Posts: 80
    edited June 2009

    I was also told that older women with early stage do not get chemo if it's not absolutely needed. A score of 26 is still in the median range, 31 and above is considered high. I'm awaiting my Oncotype results myself, and am 67 years old (only for another two weeks...)

    elisheva.

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  • knowledgeforpower
    knowledgeforpower Member Posts: 184
    edited June 2009

    I am 58, my Oncotype was 26 and my oncologist recommended chemotherapy.  Chemo reduced my recurrence from 17% to 12% and the center I go to recommends chemo if it reduces your recurrence by 5%.   I had 4 rounds of adriamycin/cytoxan, it was not a lot of fun but it was very doable and I worked through chemo.  I just started Aromasin and am about to start radiation. 

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  • patriciaten
    patriciaten Member Posts: 1
    edited June 2009

    Hi, I was diagnosed last August when I was 44 and pre-menopausal with IDC, 4 mm (yes - tiny!), Grade 3, 0/1, ER+/PR+, HER2-.  I had a WLE with clear margins in September.  After surgery, my docs decided based upon how aggressive the cancer seemed to have an oncotype test done to decide if they would recommend chemo.  My oncotype score came back at 29 so I did 4 rounds of chemo and 33 radiation treatments.  Finished with all of that in late March. 

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  • jr975
    jr975 Member Posts: 2
    edited June 2009

    Is 23 considered high?   I have already started radiation and just got my oncotype results.  My medical oncologist was so sure that I would score low that he recommended going ahead with the radiation before we got the results.  In fact, he did not think that I should have had the test done.  My tumor was less than 1 cm.      I am seeing him tomorrow but freaking out in the meantime that maybe I should have had chemo first.

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  • elisheva
    elisheva Member Posts: 80
    edited June 2009

    Received my Oncotype  score today:   26. Will find out on Tuesday (6/9) what treatment the dr. suggests. elisheva.

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  • katsOK
    katsOK Member Posts: 142
    edited June 2009

    I have a oncotype score of 27, grade 3, stage 2, ER/PR +, Her2 -  0/3 nodes, and I will be 66 this week.  I am starting chemo TC x 4 this next week.  The oncologist left it up to me to decide.

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  • hlya
    hlya Member Posts: 484
    edited June 2009

    knowledgeforpower:



    Size/stage doesn't mean the tumor is not aggressive, it just means you caught it at early stage. Grade/HER2 make difference. Your mitotic is 2 and HER2 negative, your tumor should not be the most aggressive one, it's closer to grade 2.

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  • hlya
    hlya Member Posts: 484
    edited June 2009

    knowledgeforpower:



    I just saw your 2nd post, seems chemo will only benefit 5% to you, hmmmm

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  • pigpat
    pigpat Member Posts: 1
    edited June 2009

    hi i was diagnosed in November with IDC 4.5mm left breast had single mastectomy DEC. 5th stared chemo and just finished 6-27-09. seeing the radiologist 7-15-09 not sure what to expect. don't know if i should do radiation how do i know if it will hurt my reconstruction, why didn't they take both breast what if i get it in the other breast i cant do this all over again.

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  • hlya
    hlya Member Posts: 484
    edited June 2009

    otter:



    What you said is another question of mine, I doubt how much Oncotype actually would benefit to us? How do they test the tumor by Oncotype? and why sometimes it's not consistant with other test? and do we really want to rely on this test?

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  • adi0303
    adi0303 Member Posts: 3
    edited March 2010

    Genomic Health does test the speciman differently than your hopsital lab- it is not consistant and that is why my test came back high (they used a speciamn that apparently was ER-, altho I was ER+) and now i am in question with it and requesting a redo-I'm very hesitant to do chemo- so If I do not feel that it will benefit much - 5 % or so, than I am not going that route,but if this redo (IF they redo the test) does also come back high from using my ER+ speciman than my window of oppertunity is closing FAST...They are very mechanical at Genomic everything is handled by a 1-2-3 step case...very frusterating seeing how they are dealing with cancer cards...

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  • LINDAGARSIDE
    LINDAGARSIDE Member Posts: 345
    edited March 2010

    I am in Canada (our medical does not pay for Onco testing) and it will cost close to $4,000 to have the test  done.  If I was anything BUT:  post menopausal; stage one; (low) grade one; mitotic count: 2; under 2 cm; wide margins (anterior 13mm and posterior 15mm) no node involvement and the fact that it is a 'well differentiated" ductal carcinoma...I would pay the money and get the test. I would consider chemo if the score came back high.

    I came very very close to asking for the onco type testing but when I realized the very slight improved survival margin it would give me (if I had to take chemo) and the side effects of the chemo it didn't seem like a logical choice for me to make.

    Of course I hope I made the right choice...as we all do.  This is such a crazy way to live, isn't it?  Asking about scores and margins and counts etc.  It is like we have become a chartered accountant but the facts and figures are not about money....but about our lives. 

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